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    • Uptake and Accuracy of the Diagnosis Code for COVID-19 Among US Hospitalizations
      JAMA
      Research
      December 22, 2020

      This study uses administrative claims data to describe trends in use of ICD-10-CM diagnosis codes for novel coronavirus patients in January-May 2020, before and afer the April 1 release of the U07.1 code to facilitate billing for and case monitoring of COVID-19.

      Coronavirus (COVID-19) Infectious Diseases
      Full Text | pdf link PDF | CME & MOC free is active quiz
    • Association of Diagnosis Coding With Differences in Risk-Adjusted Short-term Mortality Between Critical Access and Non–Critical Access Hospitals
      JAMA
      Research
      August 4, 2020

      This study uses Medicare data to estimate mortality differences for common medical conditions (pneumonia, heart failure, chronic obstructive pulmonary disease, urinary tract infection, others) at US critical access vs non–critical access hospitals between 2007 and 2017 with vs without adjustment for discharge diagnosis counts to assess the extent to which coding practices rather than illness severity might account for observed mortality differences.

      Health Disparities Health Policy Cardiology Chronic Obstructive Pulmonary Disease Pulmonary Medicine
      Full Text | pdf link PDF free
    • Relative Value Units and the Measurement of Physician Performance
      JAMA
      Opinion
      September 24, 2019

      This Viewpoint argues for separation of physician performance measurement from RVU production as a means to refocus physicians away from billing toward patient-centered values that could improve patients’ experience, reduce potential harms from the overtreatment that RVUs incentivize, and improve physicians’ work life and satisfaction.

      Health Care Economics, Insurance, Payment Health Care Quality Health Policy Performance Measures
      Full Text | pdf link PDF has multimedia
    • Measurement of Fall Injury With Health Care System Data and Assessment of Inclusiveness and Validity of Measurement Models
      JAMA Network Open
      Research
      August 21, 2019

      This diagnostic study uses Health and Retirement Survey and linked Medicare data to develop and validate an administrative approach to identifying older adults with fall-related injuries and to quantify the inclusiveness and validity across a spectrum of potential diagnoses of fall-related injuries.

      Emergency Medicine Geriatrics Trauma and Injury
      Full Text | pdf link PDF open access
    • The Review of Systems, the Electronic Health Record, and Billing
      JAMA
      Opinion
      July 9, 2019

      In the context of a Centers for Medicare & Medicaid Services proposal to simplify evaluation and management (E/M) documentation guidelines by 2021, this Viewpoint reviews the problems with current implementation of review-of-systems history taking in electronic health records (EHRs), including information overload, lack of follow-up of findings, clinical irrelevance to some patients and visits, and dishonesty in documentation.

      Electronic Health Records Patient Care Workflow and Process Technology and Finance
      Full Text | pdf link PDF has multimedia
    • Gaming, Upcoding, Fraud, and the Stubborn Persistence of Unstable Angina
      JAMA Internal Medicine
      Opinion
      February 1, 2019
      Acute Coronary Syndromes Cardiology Percutaneous Coronary Intervention Health Care Economics, Insurance, Payment Ischemic Heart Disease
      Full Text | pdf link PDF has multimedia
    • Temporal Trends in Unstable Angina Diagnosis Codes for Outpatient Percutaneous Coronary Interventions
      JAMA Internal Medicine
      Research
      February 1, 2019

      This study examines the appropriate use of percutaneous coronary interventions in New York, Michigan, and Florida using Healthcare Cost and Utilization Project state databases.

      Acute Coronary Syndromes Cardiology Percutaneous Coronary Intervention Health Care Economics, Insurance, Payment Ischemic Heart Disease
      Full Text | pdf link PDF free has multimedia
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